When and why do you need an antibiotic?

Dr. Lavanya Boddu

Wednesday

Jan 26, 2011 at 12:01 AMJan 26, 2011 at 7:17 AM

Dr. Lavanya Boddu with Springfield Priority Care in Illinois provides the answers in a Q-and-A on the differences between bacterial and viral infections and when you might need to be treated with an antibiotic.

Dr. Lavanya Boddu with Springfield Priority Care in Illinois provides the answers in a Q-and-A on the differences between bacterial and viral infections and when you might need to be treated with an antibiotic.

Q. Why would you need an antibiotic?

A. Antibiotics treat bacterial infections and are not effective against viral infections. They do not help with the flu or a cold. Although, sometimes there can be a superficial bacterial infection involved with a cold or flu and, in that case, antibiotics would be helpful.

Q. How does a fever factor in needing an antibiotic?

A. Duration, pattern and intensity of fever with associated symptoms help determine the need of antibiotics. Here are some characteristics to consider:

A fever for a couple days that starts getting better but comes back high grade after another few days tends to be more bacterial. Although, viral fevers can be high grade for couple days and low grade the next few days before total recovery.

Ongoing fevers may be bacterial. Also, an ongoing fever after three days on antibiotics may be viral or a germ that is not susceptible to the antibiotic that you are already on, and you would need a recheck.

Fever after a week or so of upper respiratory tract infection can be bacterial. Associated symptoms, such as nausea, vomiting, diarrhea, painful urination, worsening sore throat, painful productive cough and headaches along with fevers, help in making the diagnosis.

Strict nausea, vomiting and diarrhea with fever can be stomach flu, and there is no need of antibiotics in that case.

Q. How does the length of time you are sick make a difference?

A. Length of sickness does make a difference. Two or three weeks of upper respiratory tract infection without fever could be cause to try antibiotics. Also, fever after a week of upper respiratory symptoms can be bacterial, but not always.

Yet, viral infections may take two to three weeks to totally get better. If its a true viral infection and antibiotics are used, it is actually the time that healed it as the virus has passed its course masked with antibiotics. But, in the case of an otherwise reasonably healthy person, it is best to give at least a week's time with supportive care and increasing fluids, over-the-counter cold medicine and pain relievers.

Although, persons with any chronic lung condition like COPD, or chronic obstructive pulmonary disease, asthma or infants should seek help sooner. Smoking is risk factor.

Of course, for kids below 5 years old, cold medicines are not encouraged. But bulb suction, fever reducers, fluids, watching activity and urinary output may be helpful.

Q. What is considered as far as nasal secretions?

A. Yellow discoloration of nasal secretion can go with both bacterial and viral infections. Just the discolored nasal secretion is not an indication for antibiotics. Clear nasal secretions can go with a simple cold or allergies for a very long period of time. Again, associated symptoms like fever duration and underlying medical conditions come into play.

So, conservative management can be tried for at least a week to two weeks. True bacterial secretions can be purulent, green, and thick with an odor some times and person can have fever and look sick.

Q. Considering the complicated nature of understanding if a virus or bacteria is the cause your sickness, how can you be tested to see if you need an antibiotic?

Flu, RSV and viral tests would involve testing nasopharyngeal secretions; mono test is a routine a blood test. All these help in determining the need for antibiotics.

Q. Do you receive an antibiotic from your doctor or pharmacist?

A. Antibiotics are prescribed by doctors and dispensed by pharmacists. Physician assistants and nurse practitioners can also prescribe them.

Q. What is a cause for concern regarding antibiotics?

A. Antibiotics are getting more and more resistant to bacteria because of its over and unnecessary use; researchers are having tough time inventing newer antibiotics.

We are putting ourselves in peril with unnecessary use of antibiotics, and they may not be useful to us when we really need them. Also, they cause side affects like diarrhea, yeast infections, nausea, vomiting, rashes and, but not limited to, allergic reactions.

So save antibiotics for the time you really need them, and help your doctor make that decision.

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